The Effect of Continuous Veno-Venous Hemofiltration or Direct Hemoperfusion With Polymyxin B-Immobilized Fiber on Neutrophil Respiratory Oxidative Burst in Patients With Sepsis and Septic Shock

• Published in: Therapeutic apheresis and dialysis 2006-02, Vol.10 (1), p.7-11
• Main Authors: Naka, Toshio, Shinozaki, Masahiro, Akizawa, Tadao, Shima, Yukihiro, Takaesu, Hideki, Nasu, Hideki
• Format: Article
• Language: English
• Subjects: Aged; Anti-Bacterial Agents - administration & dosage; Blood; Cell activation; CRRT; Direct hemoperfusion; Female; Fibers; Hemofiltration; Hemoperfusion; Humans; Hydrogen peroxide; Leukocytes (neutrophilic); Male; Neutrophil; Neutrophil Activation - physiology; Polymyxin B; Polymyxin B - administration & dosage; Polymyxins; Purification; Reactive oxygen species; Respiratory Burst - physiology; Respiratory oxidative burst; Sepsis; Sepsis - physiopathology; Sepsis - therapy; Septic shock; Shock, Septic - physiopathology; Shock, Septic - therapy; Superoxide
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/j.1744-9987.2006.00339.x

:  Neutrophil activates and injures tissues and organs during sepsis or septic shock. Blood purification therapies such as continuous veno‐venous hemofiltration (CVVH) and direct hemoperfusion with polymyxin‐immobilized fiber (PMX‐DHP) have been used for the treatment of sepsis and septic shock, however, the effects of such therapies on neutrophil activation have previously been poorly understood. We sought to evaluate neutrophil reactive oxygen species (ROS), especially H2O2 production, in the pathophysiology of sepsis or septic shock and the effect of CVVH or PMX‐DHP on neutrophil ROS. Seven critically ill septic patients requiring CVVH (and 12 matched septic patients who did not require CVVH as control) and seven septic shock patients treated with PMX‐DHP were studied. We found that patients with sepsis or septic shock had significantly higher levels of neutrophil ROS compared with normal volunteers (183 ± 42, 292 ± 90, and 103 ± 30) (P